Technical Guidelines for Integrated Disease Surveillance ... - PHRplus

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Table 6: Alert and epidemic/action threshhold for priority diseases under surveillanceDisease/condition Alert threshold Action/epidemic thresholdAcute Flaccid Paralysis (AFP/Polio)1 suspected case 1 confirmed caseAIDSIntervention targets prevention so there is no need towait for any index case or number of cases asthreshold to take actionBuruli ulcerIncreasing number of cases seenCholera 1 suspected case 1 confirmed case where it has not been reportedbeforeDiarrhoea with bloodIncreasing number of cases ifdiarrhoea with blood over shortperiod of timeIf the suspected cases have been confirmedDiarrhoea in children under 5yearsDracunculiasis (guinea wormdisease)Increasing number of cases in ashort time1 suspected case 1 confirmed caseLeprosy 1 suspected case 1 confirmed caseLymphatic filariasisMalariaIncreasing number of cases or deaths in a short timeIncreasing number of casesHyperendemic, threshold not applicableMeasles 1 suspected case Confirmed outbreakMeningitis In population greater than 30,000:5 cases per 100,000 inhabitantsper weekPopulation less than 30,000: 2cases in 1 week or an increase inthe number of cases compared tothe same time in previous yearsPopulation greater than 30,000: In one week, 15cases per 100,000 inhabitants per week confirmsepidemic in all situationsIf no epidemic during last 3 years and vaccinecoverage against meningococcal meningitis is
3.3.4 Summarise the analysis resultsConsider the analysis results with the following factors in mind:Trends for inpatient cases describe increases and decreases for the most severe cases. Deaths are mostlikely to be detected for cases that are hospitalized. The reporting of the case according to thedefinition is likely to be more accurate than those reported for outpatient cases.Increases and decreases may be due to factors other than a true increase or decrease in the number ofcases and deaths being observed. The programme objectives for the disease reduction activities in anarea should be to decrease the number of cases and deaths over time.If this decrease is not occurring, and the number of cases is remaining the same or increasing, considerwhether any of the following factors are affecting reporting: Has there been a change in the number of health facilities reporting information? Has there been any change in the case definition that is being used to report the disease orcondition? Is the increase or decrease a seasonal variation? Has there been a change in denominator (e.g. census results)? Has there been a change in screening or treatment programmes? In community outreach or healtheducation activities that would result in more people seeking care? Has there been a recent immigration to or emigration from the area or increase in refugee orinternally displaced populations? Has there been any change in the quality of services being offered at the facility? For example,lines are shorter, health staff are more helpful, drugs are available, clinic fees are charged,attitude of staff in keeping records.3.3.5 Compare this month’s achievement towards disease reduction targetsMany public health programmes have set disease reduction targets. There may be targets for individualhealth facilities, for communities and for the district as a whole. Collaborate with the managers of the publichealth activity programmes to discuss progress towards the targets based on the analysis results.If analysis results indicate that the programme strategy is not leading to a change or an increase in thenumber of cases being detected and treated, then discuss ways to improve the situation. For example, any increasesor lack of decline in the number of cases should prompt further inquiry and action to improve the qualityof the public health programme. Consider improvements such as: Information, education and communication (IE&C) messages Improving drug availability for pneumonia case management in children under 5 years of age Improving drug availability at least for pregnant women and children during the malaria season Working with community health staff to improve community awareness about when to bring children tothe health facility for treatment for diarrhoea with dehydration, pneumonia and malaria Expanding HIV/AIDS prevention education to reach youth not in school Improving immunization coverage in areas of highest risk for a given vaccine-preventable disease(measles, neonatal and maternal tetanus, yellow fever)Section 3: Analyse Data41
Page 3: Technical Guidelines forIntegrated
Page 6 and 7: 3.3.1 Review the updated charts, ta
Page 8 and 9: 7.1.2 Monitor timeliness and comple
Page 10 and 11: List of TablesTable 1: Surveillance
Page 13: AcronymsAFROAFPAIDSCBSCBSWCDCDHMTE-
Page 18 and 19: An ill person presents to medical a
Page 20 and 21: How are surveillance functions desc
Page 22 and 23: 4.0 Investigate** 5.0 Respond 6.0 P
Page 24 and 25: National4.0 Investigate** 5.0 Respo
Page 26 and 27: In general, the health of Ghanaians
Page 28 and 29: How does Ghana’s MOH/GHS support
Page 30 and 31: 1.0 Identify Cases of Priority Dise
Page 32 and 33: 1.2 Improve district procedures for
Page 35 and 36: Section 2Report Priority Diseases a
Page 37 and 38: Name of diseaseRoutine summary repo
Page 39 and 40: Identify and train CBS volunteers o
Page 41: Clinicians, ward nurses or other re
Page 44 and 45: 3.0 Analyse DataAnalysing trends of
Page 46 and 47: 3. Label all the rows and columns,
Page 48 and 49: Figure 4: Meningitis cases from Bol
Page 50 and 51: The first step in analysing data by
Page 52 and 53: 3.2.3.3 Calculate case fatality rat
Page 56 and 57: 3.4 Use the analysis results to imp
Page 58 and 59: 4.0 Investigate Reported Outbreaks
Page 60 and 61: 4.4 Prepare to conduct an investiga
Page 62 and 63: Review laboratory results with the
Page 64 and 65: Draw a histogram representing the c
Page 66 and 67: If the shape of the curve suddenly
Page 68 and 69: 5.0 Prepare and Respond to Outbreak
Page 70 and 71: Periodically review and update othe
Page 72 and 73: 3. Select appropriate communication
Page 74 and 75: Improve safe disposal of human wast
Page 76 and 77: Table 7: Daily water needs per pers
Page 78 and 79: Recommendations for improving epide
Page 80 and 81: 6.0 Provide FeedbackData are report
Page 82 and 83: The newsletter can be produced simp
Page 84 and 85: 7.0 Evaluate and Improve Surveillan
Page 86 and 87: Table 8 lists possible indicators t
Page 88 and 89: Priority diseases are recorded in t
Page 90 and 91: Indicators for measuring quality of
Page 93 and 94: Section 8Community-based Surveillan
Page 95 and 96: members to take action in the event
Page 97 and 98: Participate in information dissemin
Page 99 and 100: Section 9Summary Guidelines for Spe
Page 101 and 102: Analyse and interpretdataReferenceT
Page 103 and 104: Buruli UlcerBackground Buruli ulce
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Cholera may cause severe dehydratio
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Respond to epidemicthresholdIf a su
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In Ghana, the disease was endemic i
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ReferenceA guide to eliminating lep
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Promote environmental sanitation: c
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Surveillance goal Use a rapid late
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OnchocerciasisBackground Filarial
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Poliomyelitis (Acute flaccid paraly
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Public health action Conduct activ
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The global HIV pandemic has been a
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Respond toepidemicAnalyse and inter
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Public health action Case finding
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Annex 1Using Assessment Results to
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Tally, compile and report summary t
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Diseases of special public health f
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Pneumonia in childrenless than 5 ye
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Other diseases of public health imp
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Annex 5Laboratory Tests for Confirm
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Suspected disease orconditionCholer
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Suspected disease orconditionDiagno
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Annex 6List of Laboratories for Con
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Annex 8Case-based Surveillance Repo
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If laboratory specimen collectedFor
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16. When the investigation of the c
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(For reporting from health facility
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13. For vaccine-preventable disease
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Annex 11Total Number of Patients Se
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Annex 12Year ___________ Quarter __
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Analysis, interpretations, comments
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C. Location of Lesion(s)19. Upper l
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Annex 15Monthly Registration of Bur
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Classification a Location of Lesion
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Annex 17Managing Public Health Surv
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Annex 19Sample Tables for Person An
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Annex 20Log of Suspected Outbreaks
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Instructions for filling suspected
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INITIAL CLINICAL HISTORYPlease use
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SPECIMEN COLLECTIONDate Sent toDate
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186Technical Guidelines for Integra
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188Technical Guidelines for Integra
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Annex 25Treat Cases During an Outbr
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Also give home-based fluids as foll
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3. Give vitamin A to children with
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Annex 26Preparing Disinfectant Solu
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If the health facility does not kee
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Message:DO YOU PREPARE FOOD SAFELY?
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Reducing exposure to mosquitoesPERS
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Annex 30Estimating Vaccine Supplies
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Annex 31Recommended Immunization Pr
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Lab analysis and results:With text,
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District Epidemic Management Commit
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Annex 35Checklist for Supervising S
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Activity Supervisory Question Answe
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Annex 36Indicators for Monitoring t
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